Finding out you’re pregnant can bring a range of emotions, questions and even a little anxiety – and that’s fine. Every pregnancy has its own rhythm, but there are a few things that are pretty much true for everyone: your body will change in stages, certain checkups are important at certain times, and knowing what to expect can make the whole journey feel a lot less overwhelming.
This guide takes you through each pregnancy trimester – what’s usually going on, what appointments matter and when, and the warning signs that should never be ignored. It's a starting point for the conversations you'll have with your doctor, not a replacement for them. Each pregnancy is unique, and your obstetrician is the best person to help you make decisions that are right for you.
First Trimester: What to Expect and Important Checkups
The first trimester is the first 12 weeks of pregnancy and is often when you will notice the most physical and emotional adjustment. The hormonal changes speed up so much during this time that symptoms such as nausea, breast tenderness, fatigue and mood swings are so common. Morning sickness, as the name suggests, can occur at any time of the day and for many women eases off by the end of the trimester, but not always.
It’s also time for your first antenatal appointment. Ideally, you see your doctor soon after you find out you're pregnant, not waiting until you are a little further along. During this first visit, your doctor will typically confirm the pregnancy, calculate your due date, check your general health and order some baseline blood tests (MedlinePlus: Prenatal Care). You may also have an early ultrasound to confirm that the pregnancy is developing in the right place and to get an accurate sense of how far along you are.
It’s worth noting that the risk of miscarriage is highest in the first trimester, which can make this period feel anxious for some women. It’s a normal feeling, but try not to let it stop you coming in for your appointments – regular monitoring is exactly how your doctor catches problems early, when there’s the most that can be done.
Second Trimester: Growth Milestones and Screening Tests
For many women, the second trimester (weeks 13 to 26) is the most comfortable period of pregnancy. Morning sickness usually disappears, energy levels increase and this is usually when you’ll feel your baby move for the first time. It’s a moment that many mothers can recall with great clarity.
Several important screening tests are usually scheduled during this trimester as well. The anomaly scan is usually done between 18 and 22 weeks and is a detailed look at your baby’s growth and development. Your doctor may also check for gestational diabetes, a type of diabetes that can occur during pregnancy, usually with a blood sugar test around 24 to 28 weeks. If you haven’t already, this is also when many women find out the sex of their baby, if they choose to.
Backaches, stretch marks and swelling in the feet are common changes in your body. These are usually not a cause for concern. But now is a great time to start really noticing your baby’s movement patterns, because you will want to have something to compare to later on in your pregnancy.
Third Trimester: Preparing for Birth
The last part of your journey, from week 27 until delivery, is when your body does the most visible work – and when appointments tend to come more often. Many clinics will move to visits every two weeks and then to visits every week as your due date approaches.
During this time your doctor will be monitoring your baby's position, growth and heart rate more closely. These details will help inform decisions about your delivery. You may also be asked about your baby’s kick counts, which are a simple way of tracking movement to see if anything needs a closer look. You may notice Braxton Hicks contractions — mild, irregular tightening of the uterus — that often start in this trimester and are your body's way of "practicing" for labour. Usually harmless, your doctor can help you tell them apart from the real thing as the due date gets closer.
Now is also a good time to start thinking about the practicalities – packing your hospital bag, understanding what to expect during labour and having a plan for how you’ll get to the hospital when the time comes.
Essential Antenatal Checkups and Tests
Antenatal care, or prenatal care, is just a fancy way of saying the regular checkups you have during your pregnancy to keep track of your health and your baby's. The global health guidance recommends at least eight minimum antenatal contacts throughout a pregnancy, but your doctor may recommend more depending on your health and any risk factors you may have .
There are a few tests and checkups that come up again and again during pregnancy and it helps to know what they are for.
Ultrasound Schedule
Most pregnancies have at least two or three ultrasounds: an early scan to confirm the pregnancy and due date, a detailed anomaly scan around the 18-22 week mark to check your baby’s development, and sometimes a later scan closer to delivery to check growth and position. Depending on your pregnancy, your doctor may want you to have other scans.
Blood Tests
Blood tests during pregnancy typically check for things like your blood type, your haemoglobin levels (to check for anaemia, which is common during pregnancy), your blood sugar, and tests for infections that could affect your baby if not treated. These are normal tests and not a sign that anything is wrong, they just help your doctor get a full picture of your health.
TT Immunisation
Tetanus toxoid (TT) immunisation is a routine part of antenatal care in Nepal and is administered to protect both mother and newborn against tetanus. Tetanus continues to pose a significant risk to non-immunised mothers and neonates in this part of the world (WHO: Tetanus Fact Sheet). Your doctor will tell you when and how many doses to take, depending on your vaccination history.
Diet and lifestyle during pregnancy
You don't need a complicated diet plan for a healthy pregnancy — the basics are more important than perfection. A healthy diet with enough protein, iron, calcium and folic acid is important to your baby's development, and your doctor will usually prescribe a prenatal vitamin to make up for any deficiencies, especially iron and folic acid.
Common problems such as tiredness and constipation may be helped by adequate fluid intake, regular meals (rather than skipping them) and light exercise, such as walking if your doctor permits. Your doctor can advise you on your own situation, but in general it is recommended that you do not eat raw or undercooked meat and eggs, unpasteurised dairy, excess caffeine and alcohol during pregnancy.
Rest is also important. Pregnancy is hard work, and allowing yourself to take it easy – especially in your third trimester – is not a privilege but part of caring for yourself and your baby.
Warning Signs at Any Time During the Pregnancy
Most pregnancies are straightforward but it’s important to know what symptoms need urgent attention rather than a ‘wait and see’ approach. These signs can happen any time during the pregnancy, not just toward the end.
Bleeding
Any vaginal bleeding in pregnancy should be checked by a doctor. It doesn’t always mean something serious is going on, but it does need to be evaluated, not monitored at home.
Reduced Fetal Movement
You get used to feeling your baby move regularly and a significant decrease in movement, especially in the third trimester, is something to get checked out promptly. Trust your gut feeling. You know your baby's normal routine better than anyone else.
Severe Headache/Swelling
Preeclampsia is a complication of pregnancy characterised by high blood pressure and often protein in the urine. Sometimes warning signs, such as a sudden severe headache, changes in vision or rapid swelling in the face and hands, are present. Preeclampsia needs prompt medical attention (MedlinePlus: Preeclampsia). That’s why blood pressure is checked at every antenatal appointment, even if you feel well.
If you notice any of these signs, don't wait until your next appointment, call your doctor or go to the hospital today.
Selecting a Maternity Hospital in Kathmandu
When you’re deciding where you’ll have your antenatal care and where you’ll finally deliver, it’s useful to think about more than just the location. Consider whether the hospital is open for obstetric and emergency care 24 hours a day, seven days a week, has a neonatal care unit in case your baby needs extra care after birth and whether you can form a relationship with your doctor throughout your pregnancy rather than seeing a different provider at every appointment.
And also ask practical questions early on, such as what documents will be required at the time of delivery, how they handle appointments and emergencies, and what kind of support is available if your pregnancy later gets classified as high risk. Knowing the answers to these questions in advance can take a lot of the guesswork out of those final weeks of pregnancy.
Delivery services at the Maternity Department at KNMC Hospital
Our Obstetrics and Gynaecology and Maternity teams at Kathmandu National Medical College & Teaching Hospital are here for mothers every step of the way during your pregnancy, from your very first antenatal visit through delivery and postnatal care. Whether your pregnancy is going smoothly or requires more careful monitoring, your care is provided by qualified obstetricians who get to know your pregnancy over time, not just on the day you deliver.
Our team includes consultants like Dr Jitendra Kumar Singh, an Obstetrics and Gynaecology specialist. We work with each mother to understand her health, her pregnancy and her preferences so that decisions about delivery are made together on what is safest for the mother and baby.
Who is Dr. Jitendra Kumar Singh
Dr. Jitendra Kumar Singh is a very experienced and talented Obstetrician, Gynaecologist, Infertility Specialist and Laparoscopic Surgeon. He has been in practice for more than 3+ years at KNMC Hospital and helped countless patients with their health problems.Dr. Singh is committed to giving his patients the best quality of care. He listens to his patients and what they need. He then creates a personalized treatment plan for each patient’s specific situation.Dr Singh is a strong proponent of patient education. He feels that patients should be taught about their health conditions and treatment options so that they can make informed choices about their care.
Services Offered:
Dr. Singh offers a wide range of services, including:
- Obstetrics and Gynaecology care
- Infertility diagnosis and treatment
- Laparoscopic and Hysteroscopic surgery
- Family planning counseling
For appointments and prenatal care:
To arrange an antenatal appointment or to discuss your pregnancy care with our Obstetrics & Gynaecology team, please contact Kathmandu National Medical College & Teaching Hospital.
Book Online: https://kathmandunational.edu.np/doctors
Emergency: 01-4771556
Ghattekulo Marga, Kathmandu, Bagmati ,Nepal
Sources
- https://medlineplus.gov/pregnancy.html
- https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302
- https://medlineplus.gov/diabetesandpregnancy.html
- https://www.who.int/publications/i/item/9789241549912
- https://www.who.int/news-room/fact-sheets/detail/tetanus
- https://medlineplus.gov/pregnancyandnutrition.html
- https://medlineplus.gov/ency/article/000898.htm
FAQs
How many antenatal checkups are recommended in Nepal?
National and WHO guidance recommends at least 8 antenatal contacts across pregnancy, your OB/GYN will personalize this based on your risk profile.
When should I start prenatal visits?
As soon as you know you're pregnant, ideally within the first trimester, early screening tests can be scheduled on time.
What foods should I avoid during pregnancy?
Avoid raw or undercooked meat/eggs, unpasteurised dairy, excess caffeine, and alcohol; ask your doctor for a full personalised list.
What documents do I need to deliver at KNMC?
Antenatal checkup records, previous ultrasound reports, and insurance details if applicable — the Maternity desk can confirm specifics.
What warning signs during pregnancy need immediate attention?
Heavy bleeding, severe abdominal pain, sudden severe headache, vision changes, or reduced foetal movement all need urgent evaluation.
Can I choose my delivery method in advance?
Your OB/GYN will discuss the safest delivery method for you and your baby based on your pregnancy's progress and any risk factors closer to your due date.
